When working with a mom presenting with sore nipples, I tell her
that latch will likely hurt a bit, but ask if she can give me 40 seconds.
 During that 40 seconds, I count deep breathing with her....IN through
the nose....2...3...4...5 and OUT through the mouth...2...3...4...5
(that's 10 seconds of one breath).  by the time the fourth breath is
over, the mom generally looks amazed to realize that she is no longer
feeling terrible nipple pain.  Then we talk about latch and positioning
and she is a convinced camper!
        BTW, I ask the mom how painful it is when a mom says it hurts.  I
use a scale where 0 is pain-free and 10 is unbearably painful.  When a
mom already has sore nipples, I look for a 1-2 response as the baby
nurses.  And tell her that now that the problem has been discovered and
fixed, this should be the worst it ever gets.
        I am amazed that some moms present with scabs and bleeding
nipples before the baby is 24 h old....

Karen Zeretzke, MEd, IBCLC
Baton Rouge, Louisiana
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